Difference of Secondhand Smoke Exposure by Type of Outdoor Smoking Facility

Abstract

In order to reduce peoples exposure to secondhand smoke (SHS), many countries implemented smoke-free laws for indoor environment. The implementation of indoor smoke-free policy has compelled smokers to go outdoor to smoke, but has increased the exposure of other people to SHS outdoors, such as the building entrance. To protect nonsmokers from outdoor tobacco smoke, some countries including Korea implement outdoor smoking policy. In Korea, outdoor smoking facilities are installed to designate outdoor smoking area. However, the evaluation of installation location or installation effect of these outdoor smoking facilities is not done properly. Smoking facilities are of three different types, namely, open, semi-closed, and closed. Thus, this study aimed to determine the differences in SHS exposure near outdoor smoking areas based on the type of smoking facility.

Field measurements were conducted to determine the difference in SHS exposure by types of outdoor smoking facility. For the field measurements, PM2.5 concentrations were measuredfor 30 minutes using SidePak monitors at 1-second interval. Two sites were considered for this method: one was the center of the outdoor smoking facility and the other was 3 m away from the entrance. The number of smokers inside and outside of the outdoor smoking facility was recorded every minute during the measurement. Through Kruskal-Wallis test, the average PM2.5 concentrations of inside and outside of the outdoor smoking facility were compared by types of smoking facility. Univariate analysis was conducted to identify significant variables that affected outside PM2.5 concentrations, and multiple regression analysis to identify factors associated with outside PM2.5 concentrations.

Smoking simulations were conducted to identify how much cigarette smoke came out of the outdoor smoking facility. The simulation experiment was conducted in an open-type smoking facility. Smoking dolls were placed at the center of the smoking facility to smoke cigarettes for 5 minutes. Three SidePak monitors were placed at 0 m, 1 m, and 3 m in a line from the entrance of the outdoor smoking facility. For each experiment, PM2.5 concentrations were measured continuously for 5 minutes in order of non-smoking, 1 cigarette, non-smoking, 2 cigarettes, non-smoking, 3 cigarettes. Experiments were repeated 8 times a day for 5 days. A total of 40 experiments was conducted. Wind speed and direction were measured at the smoking point using a wind meter. Univariate analysis was conducted to identify significant variables that affected outside PM2.5 concentrations and peak occurrence rates. Multiple regression analysis was conducted using significant variable found in univariate analysis to identify factors associated with outside PM2.5 concentrations and peak occurrence rates.

For the field measurement, the average inside PM2.5 concentration of the outdoor smoking facility varied significantly by types of outdoor smoking facility (p=0.022). The average inside PM2.5 concentrations for open type was 113.4 μg/m3 ± 93.9 μg/m3, semi-closed type was 266.7 μg/m3 ± 213.9 μg/m3, and closed type was 785.6 μg/m3 ± 835.4 μg/m3. The inside PM2.5 levels were very high regardless of types of smoking facility. The average outside PM2.5 concentrations for open type was 11.6 ± 18.2 μg/m3, semi-closed type was 4.7 ± 3.9 μg/m3, and closed type was 2.2 μg/m3 ± 6.0 μg/m3. The average outside PM2.5 concentrations of outdoor smoking facility did not vary significantly by types of smoking facility, but were affected by the number of smokers inside and outside of the smoking facility. The average outside PM2.5 concentration increased as the number of inside (p<0.0001) and outside smokers (p=0.031) increased. For the smoking simulations, the outside PM2.5 concentrations were affected by the number of cigarettes smoked, the distance from the entrance of the outdoor smoking facility, and the wind speed. The average outside PM2.5 concentrations and the average peak occurrence rates increased significantly as the number of cigarettes smoked increased, the distance from the entrance decreased, and the wind speed increased (p<0.0001 for all).

This study identified the status of outdoor smoking facilities and the factors influencing the exposure to SHS outside of the smoking facility. As many smokers using outdoor smoking facility smoked outside of the facility, nonsmokers and pedestrians are exposed to SHS. When smokers only were inside of the outdoor smoking facility, the effect of SHS was observed at 3 m away from the entrance of the smoking facility. This study provided a scientific basis for establishing rules or policies concerning the management and installation location of outdoor smoking facilities.